Credentialing Specialist Position Available In Volusia, Florida
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Job Description
Credentialing Specialist 3.8 3.8 out of 5 stars
Holly Hill, FL Job Title:
Credentialing Specialist The Credentialing Specialist is a well-organized, positive, professional responsible for credentialing and re-credentialing FQHC providers for each client assigned to them. The Credentialing Specialist will routinely interact with the client and Synergy billing operations in support of credentialing needs that arise and address any concerns identified in weekly meetings.
Supervisor:
Reports directly to the Credentialing Manager.
Essential Functions:
Oversight of the credentialing activities for the client account, including but not limited to credentialing and re-credentialing of all providers. Clear, constant communication with clients and payers to address and resolve any questions or concerns. Payer communication as needed. Collaborate with client billing operations manager and team members on credentialing and re-credentialing needs. Attend weekly meetings with client and management. Maintain strict confidentiality and adhere to all HIPAA guidelines/regulations. Ensure commitments to clients are met.
Education:
High School Diploma or GED required. Credentialing certificate preferred, at least (1) one to (2) two years of previous credentialing experience or demonstrated mastery in Credentialing Associate role at Synergy required.
Skills/Experience:
1. At least (1) one to (2) two years of credentialing experience. 2. A background in FQHC and/or medical facility preferred. 3. Knowledge of medical insurance credentialing practices. 4. Knowledge of insurance credentialing forms in accordance with the CAQH. 5. Knowledge of business office procedures. 6. Comprehensive understanding of how to process paper and electronic credentialing forms. 7. Ability to operate a computer and basic office equipment. 8. Ability to operate a multi-line telephone system. 9. Intermediate skill using Microsoft Office suite. 10. Ability to establish and maintain effective working relationships with insurance company representatives, colleagues, clients, and patients if needed. 11. Excellent verbal and written communication skills.
Environmental/Working Conditions:
Requires sitting and standing associated with a normal office/classroom environment. Manual dexterity is needed for using a calculator.